565 research outputs found
Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis
No full textINTRODUCTION: A rising incidence of kidney stone disease has led to an increase in ureteroscopy (URS) and shock wave lithotripsy (SWL). Our aim was to compare the cost of URS and SWL for treatment of stones.METHODS: A systematic review and meta-analysis based on Cochrane and PRISMA standards was conducted for all studies reporting on comparative cost of treatment between URS and SWL. The cost calculation was based on factual data presented in the individual studies as reported by the authors. English language articles from January 2001 to December 2017 using Medline, PubMed, EMBASE, CINAHL, Cochrane library and Google Scholar were selected. Our study was registered with PROSPERO (International prospective register of systematic reviews)-registration number CRD 42017080350.RESULTS: A total of 12 studies involving 2012 patients (SWL-1243, URS-769) were included after initial identification and screening of 725 studies with further assessment of 27 papers. The mean stone size was 10 and 11 mm for SWL and URS, respectively, with stone location in the proximal ureter (n = 8 studies), distal ureter (n = 1), all locations in the ureter (n = 1) and in the kidney (n = 2). Stone free rates (84 vs. 60%) were favourable for URS compared to SWL (p < 0.001). Complication rates (23 vs. 30%) were non-significantly in favor of SWL (p = 0.11) whereas re-treatment rates (11 vs. 27%) were non-significantly in favor of URS (p = 0.29). Mean overall cost was significantly lower for URS (3627) (p = 0.03). The included studies had high risk of bias overall. On sub-analysis, URS was significantly cost-effective for both stones < 10 and ≥ 10 mm and for proximal ureteric stones.CONCLUSION: There is limited evidence to suggest that URS is less expensive than SWL. However, due to lack of standardization, studies seem to be contradictory and further randomized studies are needed to address this issue.</p
From substance to process: a meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care
No full textResearch suggests that a ‘placebo’ can improve conditions common in primary care including pain, depression, and irritable bowel syndrome. However, disagreement persists over the definition and clinical relevance of placebo treatments. We conducted a meta-ethnographic, mixed-research systematic review to explore how healthcare professionals and patients understand placebos and their effects in primary care. We conducted systematic literature searches of five databases – augmented by reference chaining, key author searches, and expert opinion – related to views on placebos, placebo effects, and placebo use in primary care. From a total of 34 eligible quantitative, qualitative and mixed-methods articles reporting findings from 28 studies, 21 were related to healthcare professionals’ views, 11 were related to patients’ views, and two were related to both groups. In the studies under review, healthcare professionals reported using placebos at markedly different frequencies. This was highly influenced by how placebos were defined in the studies. Both healthcare professionals and patients predominantly defined placebos as material substances such as ‘inert’ pills, despite this definition being inconsistent with current scientific thinking. However, healthcare professionals also, but less prevalently, defined placebos in a different way: as contextual processes. This better concurs with modern placebo definitions, which focus on context, ritual, meaning, and enactivism. However, given the enduring ubiquity of substance definitions, for both healthcare professionals and patients, we question the practical, clinical validity of stretching the term ‘placebo’ towards its modern iteration. To produce ‘placebo effects’, therefore, primary healthcare professionals may be better off abandoning placebo terminology altogether
Human TUBB3 mutations perturb microtubule dynamics, kinesin interactions, and axon guidance
No full textWe report that eight heterozygous missense mutations in TUBB3, encoding the neuron-specific beta-tubulin isotype III, result in a spectrum of human nervous system disorders that we now call the TUBB3 syndromes. Each mutation causes the ocular motility disorder CFEOM3, whereas some also result in intellectual and behavioral impairments, facial paralysis, and/or later-onset axonal sensorimotor polyneuropathy. Neuroimaging reveals a spectrum of abnormalities including hypoplasia of oculomotor nerves and dysgenesis of the corpus callosum, anterior commissure, and corticospinal tracts. A knock-in disease mouse model reveals axon guidance defects without evidence of cortical cell migration abnormalities. We show that the disease-associated mutations can impair tubulin heterodimer formation in vitro, although folded mutant heterodimers can still polymerize into microtubules. Modeling each mutation in yeast tubulin demonstrates that all alter dynamic instability whereas a subset disrupts the interaction of microtubules with kinesin motors. These findings demonstrate that normal TUBB3 is required for axon guidance and maintenance in mammals.Max A. Tischfield, Hagit N. Baris, Chen Wu, Guenther Rudolph, Lionel Van Maldergem, Wei He, Wai-Man Chan, Caroline Andrews, Joseph L. Demer, Richard L. Robertson, David A. Mackey, Jonathan B. Ruddle, Thomas D. Bird, Irene Gottlob, Christina Pieh, Elias I. Traboulsi, Scott L. Pomeroy, David G. Hunter, Janet S. Soul, Anna Newlin, Louise J. Sabol, Edward J. Doherty, Clara E. de Uzca´ tegui, Nicolas de Uzca´ tegui, Mary Louise Z. Collins, Emin C. Sener, Bettina Wabbels, Heide Hellebrand, Thomas Meitinger, Teresa de Berardinis, Adriano Magli, Costantino Schiavi, Marco Pastore-Trossello, Feray Koc, Agnes M. Wong, Alex V. Levin, Michael T. Geraghty, Maria Descartes, Maree Flaherty, Robyn V. Jamieson, H.U. Møller, Ingo Meuthen, David F. Callen, Janet Kerwin, Susan Lindsay, Alfons Meindl, Mohan L. Gupta, Jr., David Pellman, and Elizabeth C. Engl
1 Wage Strikes in 1880s America: A Test of the War of Attrition Model
No full textWe thank Joseph Ferrie and Janet Currie for sharing their data and for helpful advice
Wage strikes in 1880s America: A test of the war of attrition model
No full textBy relating strike outcomes and durations to the value of the disputed wage change and to the cost to each side of continuing the strike, this paper tests the hypothesis that the war of attrition with asymmetric information model of strikes accurately describes the characteristics of strikes over wages in the United States in the early to middle part of the 1880s. That hypothesis is not rejected by linear, probit, or nonparametric kernel estimation. Specifically, variables that decrease a side's cost of striking or increase its opponent's cost are shown to increase its maximum holdout time, and vice versa, and strike duration increases with the value of the prize in dispute and with uncertainty about the outcome. Alternative game theoretic models of strikes--signaling and screening models, and models with ongoing negotiations--do not fit the data as well. We also explore why the strikes took the form of wars of attrition, and why later strikes did not. Our results have implications for modern union behavior in the face of globalization.Strikes Labor unions War of attrition United States
Czech wine consumers: maturing with age?
No full textThe purpose of this study is to identify the most important motivations for drinking wine and the factors influencing wine purchase in the Czech Republic and to ascertain if there are significant differences between genders and age groups. An online survey was conducted, using e-mail and social networks, of wine consumers in one of the 14 regions of the Czech Republic. This resulted in a sample of n=237. Spearman’s correlation test was conducted to find correlations between wine consumption and age and the chi-square test for differences between genders. Four motivations were found to be significantly correlated with age – to be sociable, to be respected, because wine is considered healthy and because it belongs with a nice meal, as well as seven factors affecting wine purchase – label, provenance, brand/producer, vintage, design of the bottle, recommendations of salesperson and a preference for the lowest priced wines. As the majority of respondents came from one of the 14 Czech regions, generalizations for the whole Czech Republic cannot be made. It is recommended that future work should include more complex segmentation. This paper contributes to the literature by exploring the Czech wine market, where very little research has been conducted so far, as well as by exploring the influence of age on the motivation for wine consumption
The HLA-E Gene encodes two differentially regulated Transcripts and a Cell Surface Protein
No full textAn HLA-E-specific oligonucleotide probe was used
to study the expressioonf HLA-E. This probed etects
two HLA-E transcripts, 1.8 and 2.7 kb in size, which
are present in varying ratios in allt issues and cell
lines investigated. We demonstrate that alternative
poly(A) site usage accounts for the differential regulation
of the two HLA-E mRNA species. Sequence
analysis of three cDNA clones, representing the two
transcripts of HLA-E, and of anH LA-E gene encoded
by cosmid cd3.14, revealed identity of gene and
cDNA in the 3’ untranslated region. S1 nuclease
protection assays confirmed that the two HLA-E
transcripts are not alternative splicing products.
Introduction of cd3.14, together with human ,&m
into the murine myeloma cell line P3X63-Ag8.653,
resulted in a cell surface expresosf ioan HLA-class
I heavy chain detectablbey indirect immunofluorescence
whereas transfection into the humBaznr n expressing
mouse L cell line, 527 was negative with
regard to cell surface expressionC. ell surface labeling
of transfectants and immunoprecipitation with
a monomorphic HLA class I-specific antibodyo r an
antibody against human &m confirmed the presence
of an HLA-E H chain on the cell surface. These
results indicate that the HLA-E gene codes for a
class I H chain that can be expressed on the cell
surface
PHOTO-THERMAL SPECTROSCOPY OF BENZENE AND PYRIDINE FILMS SUPPORTED ON METAL SURFACES.
No full textAuthor Institution: Department of Chemistry, University of MichiganThe electronic absorption spectra of physisorbed and chemisorbed pyridine and benzene on metal surfaces have been recorded at temperatures between 8 K and 300 K using a novel photo-thermal spectroscopy. The photo-calorimetric nature of the experiment makes possible the quantitation of absorption cross-section and the determination of surface coverage. The experimental method permits an improvement in signal recovery from noise over other techniques used in the electronic spectroscopy of surfaces and may also be employed to obtain the vibrational spectra surface adsorbates at monolayer coverage. Additional advantages and some disadvantages of the method relative to other techniques for surface spectroscopy will be discussed. The spectra of pyridine and benzene have been obtained on evaporated films of aluminun. Silver, gold and nickel, The results may be interpreted in terms of Surface structure, reorganization of the surface film, chemisorption and physisorption."
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